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Suggest Alternative Medication For Nifedipine Taken For Calcium Channel Blockers
Question: You have my meds list and have responded to my initial questions. My ID is hcmg 780115. Since your response, I have got advice from my periodonist. He tells me that Amlodipine and Lercanidipine(recommended by Dr Sharka) are just as bad as Nifedipine which caused gingival hyperplasia which resulted in gum surgery which cost over $4,000. I can not risk nor afford that procedure again!!! The additional tests that Dr Sharka(located in his answer to my initial inquiry) need to be discussed with my Cardiologist. My question today is there any other non-calium channel blocker HBP meds on the market that can be prescribed that will lower my systolic BP. My systolic is consistently High. My dystolic and heart are OK. Please advise!
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello again, dear XXXXXXX
I am glad to discuss with you again and be helpful to you.
Regarding your concern, let me explain that there are no ideal drugs for hypertension, as each of them has potential adverse effects more pronounced in certain individual.
When I explained you about about alternative (to Nifedipine) calcium channel blockers I mentioned drugs like Amlodipine and Lercanidipine, because they have a much lower prevalence of such an adverse effect compared to Nifedipine.
In fact, gingival hyperplasia has been prescribed to be present in around 14% to 83% of patients treated with Nifedipine (the frequency differs according to several observational studies), meanwhile Amlodipine and Lercanidipine have a significantly much lower prevalence of such adverse effect (gingival hyperplasia).
I personally would try any of these two alternatives first.
Nevertheless, as your periodontist doesn't prefer any other calcium channel blockers alternative, let me suggest you to focus on another effective antihypertensive drug class, such as alpha-1 receptor blockers (alpha-1 antagonists), like Doxazosin, Prazosin, Terazosin.
As you are actually taking one of them (Doxazosin), I recommend you considering a dose increase.
You are taking 4 mg daily so you need to increase its dose gradually (usual dose range 1-16 mg once daily).
After having the first dose the subsequent increases are made at bedtime to avoid syncope.
Is is strongly recommended that you follow your attending doctor advice and take the drug under close medical supervision.
You need to discuss with your doctor on the above mentioned issues.
In case of any further uncertainties feel free to ask me again.
Meanwhile, I remember you to check all the above mentioned lab tests mentioned in our previous thread.
Kind regards,
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello again, dear XXXXXXX
I am glad to discuss with you again and be helpful to you.
Regarding your concern, let me explain that there are no ideal drugs for hypertension, as each of them has potential adverse effects more pronounced in certain individual.
When I explained you about about alternative (to Nifedipine) calcium channel blockers I mentioned drugs like Amlodipine and Lercanidipine, because they have a much lower prevalence of such an adverse effect compared to Nifedipine.
In fact, gingival hyperplasia has been prescribed to be present in around 14% to 83% of patients treated with Nifedipine (the frequency differs according to several observational studies), meanwhile Amlodipine and Lercanidipine have a significantly much lower prevalence of such adverse effect (gingival hyperplasia).
I personally would try any of these two alternatives first.
Nevertheless, as your periodontist doesn't prefer any other calcium channel blockers alternative, let me suggest you to focus on another effective antihypertensive drug class, such as alpha-1 receptor blockers (alpha-1 antagonists), like Doxazosin, Prazosin, Terazosin.
As you are actually taking one of them (Doxazosin), I recommend you considering a dose increase.
You are taking 4 mg daily so you need to increase its dose gradually (usual dose range 1-16 mg once daily).
After having the first dose the subsequent increases are made at bedtime to avoid syncope.
Is is strongly recommended that you follow your attending doctor advice and take the drug under close medical supervision.
You need to discuss with your doctor on the above mentioned issues.
In case of any further uncertainties feel free to ask me again.
Meanwhile, I remember you to check all the above mentioned lab tests mentioned in our previous thread.
Kind regards,
Dr. Iliri
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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